Developing a pharmacy access to hormonal contraception model in California: Lessons learned and opportunities for policy change

Making emergency contraception available directly in pharmacies is an important model that has opened doors for other hormonal contraceptives. Optimizing the role pharmacists and pharmacies play in increasing access to contraceptives and reproductive health services is vital to meeting women's health needs. Research shows there is a need and broad support for direct access to hormonal contraception in pharmacies, provided the pharmacist screens a woman first. This signifies an important role for pharmacists in expanding access to hormonal contraception.

In 2006 and 2007, Pharmacy Access Partnership convened a group of health professionals and advocates to develop a progressive pharmacy access to hormonal contraception pilot program in California. Our research question centered around whether utilizing pharmacists and pharmacies as initial hormonal contraception providers increased overall access without posing additional risks. The pilot study aimed to examine the feasibility and acceptability of pharmacy access to hormonal contraception among consumers, providers and payers. Building on the lessons learned and outstanding questions from Washington's Direct Access study, we worked to facilitate consumer program participation by simplifying the consent process, using less restrictive participation guidelines, especially related to weight, expanding participant age range, and considering barriers facing low-income women. Increasing patient and provider education around unbundling pelvic and Pap exams as prerequisites to initiating hormonal contraception was identified as paramount to our success.

Lessons learned from program development will be shared, particularly including addressing stakeholder concerns, similar policy and program opportunities in other states, and other policy areas of potential impact.